Culture, Anatomy Are Key Factors for Plastic Surgeons Performing 'Asian Rhinoplasty'
Most Asian Patients Want to Improve Their Appearance While Maintaining Their Ethnicity, Says Report in PRS GO

Philadelphia – As more Asian patients seek cosmetic surgery to improve the appearance of their nose, plastic surgeons need to know about some important factors affecting the success of 'Asian rhinoplasty,' reports a paper in Plastic and Reconstructive Surgery—Global Open®, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).

Cultural as well as anatomical considerations affect communication and choice of surgical technique for plastic surgeons performing rhinoplasty in Asian patients, according to the article by Dr. Clyde H. Ishii of Honolulu. He writes, "Surgeons performing Asian rhinoplasty must seek to deliver the ideals of this procedure while maintain the essential features of each ethnic group."

Growing Interest in Rhinoplasty by Asian Patients

Dr. Ishii's article is prompted by the "tremendous growth" of cosmetic surgery in certain Asian countries, as well as among Asian people living in other parts of the world. Rhinoplasty is second only to cosmetic eyelid surgery (blepharoplasty) among Asian patients. (Dr. Ishii notes that he uses the term "Asian" to refer to people of Eastern, Southeastern, and Southern Asian backgrounds—such as Chinese, Japanese, and Koreans, among others.)

Why are more Asian patients seeking rhinoplasty now? The trend reflects changes in the Asian concept of beauty, largely influenced by Western culture, according to Dr. Ishii.

He notes that Asian women interested in cosmetic surgery are likely to want larger eyes, a higher nose with more definition, and a smaller face. "However," he adds, "they still want to preserve their ethnic identity by refining their Asian features rather than totally Westernizing their appearance."

While good communication between the patient and surgeon is always essential, communication may pose special challenges with Asian patients. "Many Asians may be reluctant to overtly state their wishes since this may be in conflict with their cultural beliefs," Dr. Ishii notes. Where there are language barriers, he suggests that photographs or computer imaging may help to clarify communication and patient expectations.

Asian Culture and Anatomy Have Implications for Cosmetic Surgery

Plastic surgeons also need to be aware of subtle differences in the anatomy of the nose between Asian and Caucasian patients—which may have important implications for rhinoplasty techniques. Compared to the "classic reduction rhinoplasty" performed in Caucasian patients, Asian patients may be more interested in augmenting the bridge ("dorsum") and tip of the nose.

These anatomical differences have important implications for the plastic surgeon planning rhinoplasty in Asian patients. Choices for augmenting the bridge of the nose include silicone and other types of implants, more commonly used in Asian countries; and grafts using the patient's own tissues, generally preferred by plastic surgeons in Western countries.

Each type of material has its advantages and disadvantages, which must be considered along with the patient's preferences. Techniques commonly used to enhance projection of the tip of the nose in may be less effective in Asian patients, Dr. Ishii also notes.

Postoperative care is similar to that in Caucasians, but Asian patients may be at higher risk of certain complications, such as excessive scarring and prolonged swelling. The use of silicone implants, more common in Asia, also carries a higher risk of complications.

Attending to these and other technical issue will help to achieve excellent cosmetic outcomes for Asian patients seeking rhinoplasty. But Dr. Ishii reminds his colleagues not to assume that all groups of Asian patients have the same anatomy; he notes, "considerable ethnic nasal and facial variations exist" among people of Asian backgrounds. As for all cosmetic plastic surgery, careful evaluation and communication with each individual patient—along with excellent surgical technique—are vital to ensure the best possible outcome and patient satisfaction.

Plastic and Reconstructive Surgery—Global Open® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.